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Protocol - Eye Diseases and Treatment in Young Children

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Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Description:

A series of 20 questions administered to parents to assess whether or not their child has/had any eye diseases and treatments. There are also questions addressing family history of eye disease.

Protocol:

1. During the past 12 months have you noticed (name of child) frequently squinting?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

2. During the past 12 months has (name of child) had difficulty drawing or coloring?

[ ] 1 yes

[ ] 2 no

[ ] 3 unable to color

[ ] 8 refused

[ ] 9 don't know

3. During the past 12 months has (name of child) appeared to have difficulty seeing?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

4. Does (name of child) close one eye when he/she is in bright sun light?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

5. Does (name of child) close or cover one eye when he/she is concentrating?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

6. When was (name of child)'s last complete eye examination, one that included dilating of pupils where the doctor used bright lights to look in the back of his/her eyes? (this would have made the child temporarily sensitive to bright light)

[ ] 1 within past 12 months

[ ] 2 1-3 years ago

[ ] 3 3-5 years ago

[ ] 4 never

[ ] 8 refused

[ ] 9 don't know

7. Has a doctor ever told you that (name of child) had amblyopia, that is poor vision that cannot be corrected with glasses or contact lenses?

[ ] 1 yes

[ ] 2 no (skip to Q9)

[ ] 8 refused (skip to Q9)

[ ] 9 don't know (skip to Q9)

a. Was that his/her...

[ ] 1 right eye

[ ] 2 left eye

[ ] 3 both

[ ] 8 refused

[ ] 9 don't know

8. Has the child ever been treated in the past for amblyopia, that is poor vision that cannot be corrected with glasses or contact lenses, or needing to wear an eye patch?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

9. Do or did any of his/her relatives have amblyopia that is, poor vision that cannot be corrected with glasses or contact lenses?

[ ] 1 yes

[ ] 2 no (skip to Q10a)

[ ] 8 refused (skip to Q11)

[ ] 9 don't know (skip to Q11)

10a. Which relative(s)? We are only interested in blood relatives.

(READ CATEGORIES AND CODE ALL THAT APPLY)

[ ] 1 mother

[ ] 2 father

[ ] 3 both parents

[ ] 4 sister (ask Q10b)

[ ] 5 brother (ask Q10b)

[ ] 6 grandparents (ask Q10b)

[ ] 7 other relative (specify:_____________) (ask Q10b)

[ ] 8 refused

[ ] 9 don't know

10b. How many of his/her (relative) have, had, or were suspected of having amblyopia?

(code refused as 8, don't know as 9)

___ sisters

___ brothers

___ grandparents

___ other relatives

[ ] 8 refused

[ ] 9 don't know

11. Does (name of child) have strabismus — that is one or both eyes are turned in, or turned out, or up or down, or crossed or wall eyes?

[ ] 1 yes

[ ] 2 no (skip to Q13)

[ ] 8 refused (skip to Q13)

[ ] 9 don't know (skip to Q13)

a. Was that his/her.....

(READ CATEGORIES)

[ ] 1 right eye

[ ] 2 left eye

[ ] 3 both

[ ] 8 refused

[ ] 9 don't know

12. Has (name of child) ever been treated for his/her strabismus that is if one or both eyes are turned in, or turned out, or up or down?

[ ] 1 yes

[ ] 2 no (skip to Q13)

[ ] 8 refused (skip to Q13)

[ ] 9 don't know (skip to Q13)

12a. What treatment did (name of child) receive?

[ ] 1 glasses or contact lenses

[ ] 2 patching

[ ] 3 eye drops

[ ] 4 vision therapy

[ ] 5 eye muscle surgery

[ ] 6 botulinum injections

[ ] 7 other (specify:_________)

[ ] 8 none

[ ] 88 refused

[ ] 99 don't know

13. Do or did any of his/her relatives have strabismus that is if one or both eyes are turned in, or turned out, or up or down?

[ ] 1 yes

[ ] 2 no (skip to Q15)

[ ] 8 refused (skip to Q15)

[ ] 9 don't know (skip to Q15)

14a. Which relative(s)? We are only interested in blood relatives

(READ CATEGORIES AND CODE ALL THAT APPLY)

[ ] 1 mother

[ ] 2 father

[ ] 3 both parents

[ ] 4 sister (ask Q14b)

[ ] 5 brother (ask Q14b)

[ ] 6 grandparents (ask Q14b)

[ ] 7 other relative (specify:_____________) (ask Q14b)

[ ] 8 refused

[ ] 9 don't know

14b. How many of his/her (relative) have, had, or were suspected of having strabismus?

(code refused as 8, don't know as 9)

___ sisters

___ brothers

___ grandparents

___ other relatives

[ ] 8 refused

[ ] 9 don't know

15. Has a doctor ever told you that (name of child) has myopia (nearsightedness) or needs to wear glasses to see far away?

[ ] 1 yes

[ ] 2 no (skip to Q17)

[ ] 8 refused (skip to Q17)

[ ] 9 don't know (skip to Q17)

a. Was that his/her...

(READ CATEGORIES)

[ ] 1 right eye

[ ] 2 left eye

[ ] 3 both

[ ] 8 refused

[ ] 9 don't know

16. Has name of child ever been treated for his/her myopia (nearsightedness)?

[ ] 1 yes

[ ] 2 no (skip to Q17)

[ ] 8 refused (skip to Q17)

[ ] 9 don't know (skip to Q17)

a. What treatment did (name of child) receive?

[ ] 1 yes

[ ] 2 no

[ ] 3 glasses or contact lenses

[ ] 4 none

[ ] 5 other (specify:_______)

[ ] 8 refused

[ ] 9 don't know

b. In the past 12 months, how many times has he/she seen an eye doctor for his/her myopia (nearsightedness)?

_____ # times

[ ] 8 refused

[ ] 9 don't know

17. Do or did any of his/her relative have myopia or (nearsightedness)?

[ ] 1 yes

[ ] 2 no (skip to Q19)

[ ] 8 refused (skip to Q19)

[ ] 9 don't know (skip to Q19)

18a. Which relative(s)? We are only interested in blood relatives.

(READ CATEGORIES AND CODE ALL THAT APPLY)

[ ] 1 mother

[ ] 2 father

[ ] 3 both parents

[ ] 4 sister (ask Q18b)

[ ] 5 brother (ask Q18b)

[ ] 6 grandparents (ask Q18b)

[ ] 7 other relative (specify:_____________) (ask Q18b)

[ ] 8 refused

[ ] 9 don't know

18b. How many of his/her (relative) have, or had myopia or nearsightedness?

(code refused as 8, don't know as 9)

___ sisters

___ brothers

___ grandparents

___ other relatives

[ ] 8 refused

[ ] 9 don't know

19. Does your child have or has (he/she) had any other eye or vision problems?

[ ] 1 yes

[ ] 2 no (skip to end)

[ ] 8 refused (skip to end)

[ ] 9 don't know (skip to end)

a. What treatment did (name of child) receive?

Specify:________________

b. When did your child receive this treatment?

Date:_________

20. Has a doctor ever told you that (name of child, for each child) ever had:

a. cataract?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(if yes) type of treatment:_________

(if yes) when:__________

b. glaucoma?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

c. retinopathy of prematurity?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

d. eye tumor/retinoblastoma?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

e. optic nerve hypoplasia?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

f. nasolacrimal duct obstruction?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

g. cortical visual impairment?

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

h. other? (specify:_________)

[ ] 1 yes

[ ] 2 no

[ ] 8 refused

[ ] 9 don't know

(IF YES) type of treatment:_________

(IF YES) when:__________

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e. tested by an expert) at the completion of personal interviews.

Equipment Needs

Either a pencil and paper or computer-assisted instrument may be used. If a computer-assisted instrument is used, computer software may be necessary to develop the instrument. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Infant, Toddler, Child

Specific Instructions:

None

Research Domain Information

Release Date:

February 26, 2010

Definition

Questions to assess various eye diseases and treatments in very young children

Purpose

A variety of eye diseases in the newborn may have life-long implications associated with visual function and ocular health. The presence of structural ocular defects in the newborn are often due to inherited ocular and/or syndromic conditions, but may also be due to environmental factors (e.g. intrauterine viruses which may cause neonatal cataracts).

Selection Rationale

The protocols selected are from standard parental questionnaires used routinely in epidemiologic studies of ocular health in children. These protocols are current, and well-established.

Language

Cantonese Chinese, English, Mandarin Chinese, Spanish

Standards

StandardNameIDSource
Common Data Elements (CDE)Child Eye Disorder Assessment3007562CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Eye diseases young children proto62685-3LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

University of Southern California, The Multi-Ethnic Pediatric Eye Disease Study (MEPEDS), 2002-2008.

Johns Hopkins University, Baltimore Pediatric Eye Disease Study (BPEDS), 2003-2007.

BPEDS Clinic Interview- Section E: Ocular History

General References

Varma R, Deneen J, Cotter S, Paz SH, Azen SP, Tarczy-Hornoch K, Zhao P; Multi-Ethnic Pediatric Eye Disease Study Group. (2006). The multi-ethnic pediatric eye disease study: design and methods. Ophthalmic Epidemiol, 13(4):253-62.

Multi-ethnic Pediatric Eye Disease Study Group. (2008). Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study. Ophthalmology, 115(7):1229-1236.

Epub 2007 Oct 22.

Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, Tielsch JM. (2009). Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study. Ophthalmology, 116(11):2128-34.

Protocol ID:

110401

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX110401_Frequently_SquintingPX110401010000During the past 12 months have you noticed (name of child) frequently squinting?4N/A
PX110401_Difficulty_Drawing_ColoringPX110401020000During the past 12 months has (name of child) had difficulty drawing or coloring?4N/A
PX110401_Difficulty_SeeingPX110401030000During the past 12 months has (name of child) appeared to have difficulty seeing?4N/A
PX110401_Close_One_Eye_Bright_LightPX110401040000Does (name of child) close one eye when he/she is in bright sun light?4N/A
PX110401_Close_One_Eye_ConcentratingPX110401050000Does (name of child) close or cover one eye when he/she is concentrating?4N/A
PX110401_Eye_Examination_Include_Pupil_DilatingPX110401060000When was (name of child)'s last complete eye examination, one that included dilating of pupils where the doctor used bright lights to look in the back of his/her eyes?4N/A
PX110401_Amblyopia_EverPX110401070100Has a doctor ever told you that (name of child) had amblyopia, that is poor vision that cannot be corrected with glasses or contact lenses?4N/A
PX110401_Amblyopia_EyePX110401070200Was that his/her...?4N/A
PX110401_Amblyopia_Treatment_EverPX110401080000Has the child ever been treated in the past for amblyopia, that is poor vision that cannot be corrected with glasses or contact lenses, or needing to wear an eye patch?4N/A
PX110401_Amblyopia_RelativePX110401090000Do or did any of his/her relatives have amblyopia that is, poor vision that cannot be corrected with glasses or contact lenses?4N/A
PX110401_Amblyopia_MotherPX110401100101Do or did his/her mother have amblyopia?4N/A
PX110401_Amblyopia_FatherPX110401100102Do or did his/her father have amblyopia?4N/A
PX110401_Amblyopia_SisterPX110401100103Do or did any of his/her sister have amblyopia?4N/A
PX110401_Amblyopia_BrotherPX110401100104Do or did any of his/her brother have amblyopia?4N/A
PX110401_Amblyopia_GrandparentsPX110401100105Do or did any of his/her grandparents have amblyopia?4N/A
PX110401_Amblyopia_Other_RelativePX110401100106Do or did any of his/her other relative have amblyopia?4N/A
PX110401_Amblyopia_Other_Relative_SpecifyPX110401100107Specify other relative.4N/A
PX110401_Amblyopia_Number_SistersPX110401100201How many of his/her sisters have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_Sisters_CodedPX110401100202How many of his/her sisters have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_BrothersPX110401100203How many of his/her brothers have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_Brothers_CodedPX110401100204How many of his/her brothers have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_Grandparents_CodedPX110401100206How many of his/her grandparents have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_Other_RelativesPX110401100207How many of his/her other relatives have, had, or were suspected of having amblyopia?4N/A
PX110401_Amblyopia_Number_Other_Relatives_CodedPX110401100208How many of his/her other relatives have, had, or were suspected of having amblyopia?4N/A
PX110401_Strabismus_EverPX110401110100Does (name of child) have strabismus - that is one or both eyes are turned in, or turned out, or up or down, or crossed or wall eyes?4N/A
PX110401_Strabismus_EyePX110401110200Was that his/her...?4N/A
PX110401_Strabismus_Treatment_EverPX110401120100Has (name of child) ever been treated for his/her strabismus that is if one or both eyes are turned in, or turned out, or up or down?4N/A
PX110401_Strabismus_Treatment_TypePX110401120201What treatment did (name of child) receive?4N/A
PX110401_Strabismus_Other_Treatment_SpecifyPX110401120202Specify other treatment.4N/A
PX110401_Strabismus_RelativePX110401130000Do or did any of his/her relatives have strabismus that is if one or both eyes are turned in, or turned out, or up or down?4N/A
PX110401_Strabismus_MotherPX110401140101Do or did his/her mother have strabismus?4N/A
PX110401_Strabismus_FatherPX110401140102Do or did his/her father have strabismus?4N/A
PX110401_Strabismus_SisterPX110401140103Do or did any of his/her sister have strabismus?4N/A
PX110401_Strabismus_BrotherPX110401140104Do or did any of his/her brother have strabismus?4N/A
PX110401_Strabismus_GrandparentsPX110401140105Do or did any of his/her grandparents have strabismus?4N/A
PX110401_Strabismus_Other_RelativePX110401140106Do or did any of his/her other relative have strabismus?4N/A
PX110401_Strabismus_Other_Relative_SpecifyPX110401140107Specify other relative.4N/A
PX110401_Strabismus_Number_SistersPX110401140201How many of his/her sisters have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_Sisters_CodedPX110401140202How many of his/her sisters have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_BrothersPX110401140203How many of his/her brothers have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_Brothers_CodedPX110401140204How many of his/her brothers have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_GrandparentsPX110401140205How many of his/her grandparents have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_Grandparents_CodedPX110401140206How many of his/her grandparents have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_Other_RelativesPX110401140207How many of his/her other relatives have, had, or were suspected of having strabismus?4N/A
PX110401_Strabismus_Number_Other_Relatives_CodedPX110401140208How many of his/her other relatives have, had, or were suspected of having strabismus?4N/A
PX110401_Myopia_Nearsightedness_EverPX110401150100Has a doctor ever told you that (name of child) has myopia (nearsightedness) or needs to wear glasses to see far away?4N/A
PX110401_Amblyopia_Number_GrandparentsPX110401100205How many of his/her grandparents have, had, or were suspected of having amblyopia?4N/A
PX110401_Myopia_Nearsightedness_EyePX110401150200Was that his/her...?4N/A
PX110401_Myopia_Nearsightedness_Treatment_EverPX110401160100Has name of child ever been treated for his/her myopia (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_Treatment_TypePX110401160201What treatment did (name of child) receive?4N/A
PX110401_Myopia_Nearsightedness_Other_Treatment_SpecifyPX110401160202Specify other treatment.4N/A
PX110401_Myopia_Nearsightedness_Seeing_Doctor_TimesPX110401160300In the past 12 months, how many times has he/she seen an eye doctor for his/her myopia (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_Seeing_Doctor_Times_CodedPX110401160301In the past 12 months, how many times has he/she seen an eye doctor for his/her myopia (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_RelativePX110401170000Do or did any of his/her relative have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_MotherPX110401180101Do or did his/her mother have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_FatherPX110401180102Do or did his/her father have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_SisterPX110401180103Do or did any of his/her sister have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_BrotherPX110401180104Do or did any of his/her brother have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_Other_RelativePX110401180106Do or did any of his/her other relative have myopia or (nearsightedness)?4N/A
PX110401_Myopia_Nearsightedness_Other_Relative_SpecifyPX110401180107Specify other relative.4N/A
PX110401_Myopia_Nearsightedness_Number_SistersPX110401180201How many of his/her sisters have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_Sisters_CodedPX110401180202How many of his/her sisters have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_BrothersPX110401180203How many of his/her brothers have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_Brothers_CodedPX110401180204How many of his/her brothers have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_GrandparentsPX110401180205How many of his/her grandparents have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_Grandparents_CodedPX110401180206How many of his/her grandparents have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_Other_RelativesPX110401180207How many of his/her other relatives have, or had myopia or nearsightedness?4N/A
PX110401_Myopia_Nearsightedness_Number_Other_Relatives_CodedPX110401180208How many of his/her other relatives have, or had myopia or nearsightedness?4N/A
PX110401_Other_Eye_Vision_ProblemPX110401190100Does your child have or has (he/she) had any other eye or vision problems?4N/A
PX110401_Other_Eye_Vision_Problem_Treatment_TypePX110401190200What treatment did (name of child) receive?4N/A
PX110401_Other_Eye_Vision_Problem_Treatment_DatePX110401190300When did your child receive this treatment?4N/A
PX110401_Cataract_EverPX110401200101Has a doctor ever told you that (name of child, for each child) ever had cataract?4N/A
PX110401_Cataract_Treatment_TypePX110401200102What treatment did (name of child) receive?4N/A
PX110401_Cataract_Treatment_DatePX110401200103When did your child receive this treatment?4N/A
PX110401_Glaucoma_EverPX110401200201Has a doctor ever told you that (name of child, for each child) ever had glaucoma?4N/A
PX110401_Glaucoma_Treatment_TypePX110401200202What treatment did (name of child) receive?4N/A
PX110401_Glaucoma_Treatment_DatePX110401200203When did your child receive this treatment?4N/A
PX110401_Retinopathy_Prematurity_EverPX110401200301Has a doctor ever told you that (name of child, for each child) ever had retinopathy of prematurity?4N/A
PX110401_Retinopathy_Prematurity_Treatment_TypePX110401200302What treatment did (name of child) receive?4N/A
PX110401_Retinopathy_Prematurity_Treatment_DatePX110401200303When did your child receive this treatment?4N/A
PX110401_Eye_Tumor_Retinoblastoma_EverPX110401200401Has a doctor ever told you that (name of child, for each child) ever had eye tumor/retinoblastoma?4N/A
PX110401_Myopia_Nearsightedness_GrandparentsPX110401180105Do or did any of his/her grandparents have myopia or (nearsightedness)?4N/A
PX110401_Eye_Tumor_Retinoblastoma_Treatment_TypePX110401200402What treatment did (name of child) receive?4N/A
PX110401_Eye_Tumor_Retinoblastoma_Treatment_DatePX110401200403When did your child receive this treatment?4N/A
PX110401_Optic_Nerve_Hypoplasia_EverPX110401200501Has a doctor ever told you that (name of child, for each child) ever had optic nerve hypoplasia?4N/A
PX110401_Optic_Nerve_Hypoplasia_Treatment_TypePX110401200502What treatment did (name of child) receive?4N/A
PX110401_Optic_Nerve_Hypoplasia_Treatment_DatePX110401200503When did your child receive this treatment?4N/A
PX110401_Nasolacrimal_Duct_Obstruction_EverPX110401200601Has a doctor ever told you that (name of child, for each child) ever had nasolacrimal duct obstruction?4N/A
PX110401_Nasolacrimal_Duct_Obstruction_Treatment_TypePX110401200602What treatment did (name of child) receive?4N/A
PX110401_Nasolacrimal_Duct_Obstruction_Treatment_DatePX110401200603When did your child receive this treatment?4N/A
PX110401_Cortical_Visual_Impairment_EverPX110401200701Has a doctor ever told you that (name of child, for each child) ever had cortical visual impairment?4N/A
PX110401_Cortical_Visual_Impairment_Treatment_TypePX110401200702What treatment did (name of child) receive?4N/A
PX110401_Cortical_Visual_Impairment_Treatment_DatePX110401200703When did your child receive this treatment?4N/A
PX110401_Other_Told_By_Doctor_EverPX110401200801Has a doctor ever told you that (name of child, for each child) ever had other?4N/A
PX110401_Other_Told_By_Doctor_SpecifyPX110401200802Specify other.4N/A
PX110401_Other_Told_By_Doctor_Treatment_TypePX110401200803What treatment did (name of child) receive?4N/A
PX110401_Other_Told_By_Doctor_Treatment_DatePX110401200804When did your child receive this treatment?4N/A